Leading the Way - Comprehensive Parkinson’s Care at Eisenhower

Parkinson’s medications are steadily improving, incrwasing the amount of on time—the period medications are working to alleviate symptoms.

In part one of the About Parkinson’s series, “Leading the Way — Comprehensive Parkinson’s Care at Eisenhower,” Healthy Living magazine presented the staff and services that define the excellence of care found at the Center. In part two, we explore the wealth of treatment options available at the Center — options that include medications and other treatment modalities — and take a look at what’s on the horizon for Parkinson’s care.

For many, if not most, Parkinson’s patients today, some sort of medication regimen serves as the primary form of treatment. Medications help to increase mobility, decrease tremors and lessen mood disturbances. However, for some people with Parkinson’s disease, drug therapy is not always the first treatment option.

“Although medications can be tremendously beneficial, there are possible side effects that must be considered,” says Dr. Neal Hermanowicz, a Board Certified Neurologist who has served as Medical Director of Eisenhower’s Phillip and Carol Traub Parkinson’s Center for the past seven years. “It is encouraging to have more tools to treat this disease, especially since no two people with Parkinson’s disease are identical. Medication regimens really must be individually tailored.” “It is encouraging to have more tools to treat this disease, especially since no two people with Parkinson’s disease are identical. Medication regimens really must be individually tailored.”

All medications currently used to treat Parkinson’s disease carry some risk of side effects, such as nausea or drowsiness, and in some cases visual hallucinations or delusional thoughts may occur. Some medications, such as levodopa — the gold standard of Parkinson’s care that helps replenish the brain’s dwindling supply of dopamine — can produce unwanted, involuntary movements.

The number of medications available to treat the symptoms of Parkinson’s disease is increasing. Rasagiline, known by the trade name Agilect®, will likely become available in the coming months. Already available in Europe and Israel, this medication is used once per day. Rasagiline is also currently under study as a means to alter the progression of Parkinson’s disease. Selegiline, known now as Eldepryl®, will be released soon in a new, more potent form, under the name of Zelopar®. Rotigotine™, a so-called dopamine agonist, much like Mirapex® and Requip®, is administered as a once per day skin patch, and will probably be available in the United States in the first half of 2006. Still more medications are now being studied as possible treatments to improve the lives of people with Parkinson’s disease.

Surgery may be an option for some people whose symptoms cannot be adequately controlled with medications, or for whom the medications have intolerable side effects. This is accomplished by stimulating structures deep within the brain through the use of an implantable stimulator. The stimulator emits an electric current, which is supplied by an external pacer similar to those used for cardiac patients. Keep in mind, however, that this surgery is not for everyone and is not a cure.

Parkinson’s Center patients have a number of opportunities to participate in research and clinical trials for new drug therapies that are on the horizon. The Center also offers neurological services, informational forums, educational and support lectures, exercise classes, and support and counseling for patients and caretakers.